Risk factors associated to hospital mortality in patients with acute kidney injury on hemodialysis

• Published in: Medwave Vol. 17; no. 2; p. e6879
• Main Authors: Linares-Linares, Mariela Alejandra, Figueroa-Tarrillo, Jorge Arturo, Cerna Viacava, Renato, Carreazo, Nilton Yhuri, Valdivia-Vega, Renzo P
• Format: Journal Article
• Language: Spanish; English
• Published: Chile 06.03.2017
• Subjects: Acute Kidney Injury - mortality; Acute Kidney Injury - therapy; Aged; Arterial Pressure; Cohort Studies; Female; Hospital Mortality; Humans; Lactic Acid - blood; Male; Middle Aged; Multivariate Analysis; Poisson Distribution; Potassium - blood; Prognosis; Renal Dialysis; Retrospective Studies; Risk Factors; risk factors; acute kidney injury; hospital mortality; renal dialysis
• ISSN: 0717-6384; 0717-6384
• DOI: 10.5867/medwave.2017.02.6879

The worldwide incidence of acute kidney injury is 18% and the overall hospital mortality can rise above 50%. In Peru, there are few series about mortality of acute kidney injury in hemodialysis patients. To identify risk factors associated to hospital mortality of acute kidney injury in hemodialysis patients. This is a retrospective cohort of patients with acute kidney injury in hemodialysis of Hospital Nacional Edgardo Rebagliati Martins gathered between January 2013 and December 2015. The sample size was 154 patients which allowed a power of 80% and a CI of 95%. ICD-10 codes were used to identify medical records of patients with acute kidney injury (N.17) and hemodialysis (Z.49). The independent variable was oliguria, and the primary outcome was hospital mortality. Poisson regression was used for multivariate analysis. We identified a total of 285 patients; 212 medical records were analyzed and 44 were excluded. Out of the 168 medical records, 129 belonged to living patients and 39 to deceased ones. The overall mortality incidence was 17.2%. The principal etiologies of acute kidney injury while in hemodialysis were sepsis (39.2%), and severe dehydration (10.8%). In the adjusted model, the risk factors associated to hospital mortality of acute kidney injury while in hemodialysis were elevated serum lactate (RR 1.09), elevated serum potassium (RR 0.93), and mean arterial pressure (RR 0.97). Lactate is an objective parameter that can predict prognosis and contributes to a better management of acute kidney injury in hemodialysis patients.